As obligate intracellular parasites, viruses must coopt basic cellular processes to enter host cells and deliver their genomes to the appropriate intracellular site for replication (45). Viral entry steps include attachment of the virus to the cell surface, penetration of the virus into the cell interior, disassembly of the viral capsid, and activation of the viral genetic program. These events are essential for the virus to transition from the extracellular environment to the cellular compartment in which viral transcription and replication occur. Entry steps also play key roles in viral pathogenesis, as these events often determine cell tropism within the infected host. Mammalian orthoreoviruses (reoviruses) are important models for studies of virus cell entry and the pathogenesis of viral disease. Reoviruses form nonenveloped, double-shelled particles that contain a segmented, double-stranded RNA genome (70). Virtually all mammals, including humans, serve as hosts for reovirus infection (84). However, reovirus causes disease primarily in the very young (44, 77, 79). Newborn mice infected with reovirus sustain injury to a variety of organs, including the brain, heart, and liver (5, 56, 84). Mechanisms of reovirus-induced disease, including cellular determinants of viral spread and tropism, are only partially understood. Reovirus entry into cells is initiated by the attachment of virions to cell surface receptors via the σ1 protein (41, 85) and internalization into cells by receptor-mediated endocytosis (6, 7, 24, 76). In cellular endosomes, virions undergo stepwise disassembly, forming discrete intermediates, the first of which is the infectious subvirion particle (ISVP) (7, 14, 74, 76). ISVPs are generated by proteolytic removal of the σ3 protein and cleavage of the μ1 protein to form particle-associated fragments δ and ϕ. Following formation of ISVPs, σ1 is shed and the μ1 cleavage fragments undergo conformational rearrangement, yielding the ISVP* (11, 12). ISVP*s penetrate endosomes to deliver transcriptionally active viral cores into the cytoplasm (54, 55). Endocytic proteases cathepsins B and L catalyze reovirus virion-to-ISVP disassembly in murine fibroblasts, although cathepsin L is the major mediator of this process (23). These proteases are expressed in most organs, including the intestine, brain, heart, and liver (78). In P388D cells, a macrophage-like cell line, cathepsin S, mediates the uncoating of some reovirus strains (28). Cathepsin S expression is largely restricted to cells and tissues of the immune system (16), which may be important during enteric infection, as reovirus replication in the intestine occurs in mononuclear cells of Peyer's patches (25, 51). Cathepsin S is known to be expressed in mononuclear cells, including alveolar macrophages in the lung (72, 73) and microglial cells in the brain (61). Cathepsins B, L, and S are responsible for unique, tissue-specific activities (65). Cathepsin B modulates pathological trypsinogen activation (30) and apoptosis induced by tumor necrosis factor alpha (29). Cathepsin L is required for hair follicle cycling and epidermal homeostasis (68). By virtue of its activity at neutral pH (9, 39), cathepsin S is thought to participate in remodeling of the extracellular matrix (72, 89). Functions of cathepsins B, L, and S intersect in the regulation of adaptive immunity. Cathepsin L cleaves the invariant chain in cortical thymic epithelial cells (52) and is hypothesized to mediate efficient endosomal protein fragmentation to ensure diverse peptide generation in the thymus (33, 43). Through these functions, cathepsin L serves to facilitate positive selection of CD4+ T cells (15, 35). Cathepsin S cleaves the invariant chain in peripheral antigen-presenting cells, leading to CD4+ T-cell activation (53). Both cathepsin L (32) and cathepsin S (67) participate in NK1.1+ T-cell selection in the thymus through proteolytic processing in thymocytes and antigen-presenting cells, respectively. As a result, cathepsin L-deficient (Ctsl−/−) and cathepsin S-deficient (Ctss−/−) mice have impairments in both CD4+ and NK1.1+ T-cell activities. Cathepsin S also processes antigen in endosomes for cross-presentation via the major histocompatibility complex class I pathway (71). Like cathepsins L (34) and S (63), cathepsin B processes endocytosed antigen for display by major histocompatibility complex class II molecules (46, 48). However, cathepsin B-deficient mice (Ctsb−/−) do not display overt immunodeficiency (65). Underscoring the importance of endosomal cathepsin proteases in host functions, viruses have usurped these enzymes to allow entry into the cytoplasm. In addition to reovirus, cathepsins catalyze proteolytic events required for membrane fusion of several important pathogens. Ebola virus requires both cathepsin B and cathepsin L for efficient cell entry (13), while severe acute respiratory syndrome coronavirus requires cathepsin L but also can utilize cathepsins B and S (36, 75). Hendra (58) and Nipah (57) viruses utilize cathepsin L for fusion protein processing, most likely at the stage of virion assembly (47). Despite the importance of cathepsins in viral growth, nothing is known about the function of these proteases in the pathogenesis of viral disease. To determine the role of cathepsin proteases in viral virulence, we studied reovirus disease by using mice lacking a single cathepsin. Mice deficient for cathepsin B, L, or S were monitored for survival, disease symptoms, and viral replication following reovirus infection. We found that following peroral inoculation of reovirus, cathepsin deficiency leads to decreased viral replication in sites of secondary replication. However, Ctsl−/− and Ctss−/− mice succumb to doses of virus nonlethal to wild-type (wt) and Ctsb−/− animals. Although viremia is not affected by cathepsin deficiency, we observed alterations in disease pathogenesis in the hearts, livers, and brains of cathepsin-deficient animals. Furthermore, treatment of wt mice with an inhibitor of cathepsin L reduces disease severity. These studies demonstrate that cathepsin activity plays a key role in viral pathogenesis and identify a new target for antiviral drug development.